other DPD Flashcards by denise lin

Causes of haemolytic anaemia

Genetic: hereditary spherocytosis (RBC membrane defect), G6PD deficiency, haemoglobulinopathies
Acquired: drugs, AI, MAHA, infection

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Heinz bodies cells on blood films

G6PD deficiency haemolytic anaemia

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Aplastic anaemia common cause

Parovirus B19

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Haemophilia (bleeding into joints) have which abnormal bleeding times

Increased APTT only

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Haemophilia A

Factor 8 deficiency

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Heamopihlia B

Factor 9 deficiency

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Anti-thyroid drugs examples

Carbimazole
Propylthiouracil (can be used in pregnancy)
Started at high dose and then decreased. Stopped when patients develop neutropenic fevers and sore throats

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Clinical features specific to Graves’ in hyperthyroidism

Exopthalmos (and proptosis due to anti-TSHr antibodies)
Thyroid acropachy
Pretibial myoxedema

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Infective endocarditis can result in

splenomegaly

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Reiter’s syndrome

Urethritis
Conjunctivitis
Reactive arthritis

This is a precursor of joint problems e.g. ankylosing spondylitis.

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Campbell de Morgan spots

normal and benign

no pathology known

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Viral hepatitis will show which LFT to be the highest?

ALT

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Hepatic cirrhosis will show which LFT to be the highest?

AST

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Spider naevi appear in anatomical distribution of SVC and above the nipple line. they suggest…

Chronic liver disease

When they are pressed in the centre, they blanch

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RDW = red cell distribution width i.e. the spread of MCV in blood film. It is increased in….

mixed anaemia picture

i.e. IDA together with pernicious anaemia/ coeliac disease (-> IDA + vitB12 def)

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osmolality equation

2(Na+K) + urea + glucose

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anion gap equation

Na + K - Cl - HCO3

If anion gap >18MM, there is met acidosis

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causes of macrocytic anaemia

alcohol
myelodysplasia
hypothyroidism
liver disease
folate/vitB12 deficiency

Prussian blue iron stain +ve

haemochromatosis

Amyloidosis histochemical stains

Congo red +ve (glomerulus)

Apple green birefringence

Cytokeratin immunohistochemical stains (epithelial marker) distinguishes between….

carcinomas and lymphomas

CD45+ve

Lymphoma

CK20+ve

Adenocarcinoma e.g. colorectal cancer

Lower GI tumours marker

Carcinogenic embryonic antigen (CEA)

present in other: stomach lung breast pancreas cancer, infections, hepatitis, IBD

Pancreatic cancer tumour marker

Ca19-9 present in other: GI tumours, pancreatitis, cirrhosis

Breast cancer tumour markers

Ca15-3 | Now Ca27-29 is better

Ovarian cancer tumour marker

Ca-125 present in other: ascites, menstruation, pregnancy

AFP is raised in

HCC Testicular cancer (also b-hCG) Pregnancy (also b-hCG)

Disseminated Intravascular Coagulation (DIC) results in

Low platelets +fibrinogen High PT/APTT High D-dimer/ fibrin degradation products -> microangiopathic haemolytic anaemia

Almost all causes of hypoNa+ are due to

Increased vasopressin Rarer causes: excess water intake, Na+ free irrigation solutions (used in TURP)

Causes of cavitating lung lesions

Infection (TB, staph, Klebsiella esp in alcoholics) Inflammation (WG, RhA) Infarction (PE) Malignancy

30 year old man presents with recurrent GI and nose bleeds. Facial examination shows mucosal membrane petechiae. What is the likely diagnosis?

Hereditary haemorrhagic telangiectasia Autosomal dominant Abnormal BVs in skin, mucous membranes, lungs, liver, brain

Eosinophils are present in...

Allergic reactions (asthma, contact dermatitis) Parasitic infection Tumours (Hodgkin's)

Mast cells are present in...

Allergic reactions | Type 1 hypersensitivity

Macrophages are present in...

Late acute inflammation Chronic inflammation - including granulomas (i.e. at the end of acute and at the start of chronic inflammation)

TB histology shows

Caseating granulomas Epithelial macrophages (Ziehl neelson stain shows acid fast bacilli)

``` What cell type do these tumours belong? Carcinomas Sarcomas Lymphoma Melanoma ```

Carcinomas - epithelial cells Sarcomas - native tissue Lymphomas - lymph cells Melanoma - skin cells

Keratin production Intercellular bridges present in which type of carcinoma?

Squamous cell carcinoma

Mucin production Glands present in which type of carcinoma?

Adenocarcinomas

Sites of origin of squamous cancers

``` Skin Head and neck Oesophagus Anus Cervix Vagina ```

Sites of origin of adenocarcinomas

``` Lung Breast Stomach Colon Pancreas ```

Giant multinuclear cells present in...

herpes simplex virus

What is monitored in HIV patients?

HIV RNA levels (viral load) and CD4 levels

vWF disease mainly presents as

epistaxis (nosebleeds)